Kelebihan Cairan (Fluid Overload) dan Hubungannya dengan Kejadian Acute Kidney Injury (Aki)

  • Erwin Kresnoadi Fakultas Kedokteran Universitas Mataram

Abstract

Mempertahankan keseimbangan cairan merupakan tujuan utama untuk pasien ICU. Pasien dengan kelebihan cairan akan mengalami peningkatan kebutuhan ventilasi serta pemanjangan waktu perawatan di ICU dan akan terjadi penurunan indeks oksigenasi. Hubungan akumulasi cairan berlebihan dan Acute Kidney Injury (AKI) sangat kompleks. Kelebihan cairan meningkatkan tekanan intra abdomen yang selanjutnya menyebabkan kongesti vena ginjal serta penurunan laju filtrasi glomerulus. Akibatnya, kelebihan cairan menjadi salah satu penanda tingkat keparahan AKI.

References

1. Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol. 2005 7;16:3365–70.

2. Payen D, de Pont AC, Sakr Y, Spies C, Reinhart K, Vincent JL. A positive fluid balance is associated with a worse outcome in patients with acute renal failure. Crit Care. 2008;12:R74.

3. Bouchard J, Soroko SB, Chertow GM, Himmelfarb J, Ikizler TA, Paganini EP, et al. Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury. Kidney Int. 2009;76:422–7.

4. Grams ME, Estrella MM, Coresh J, Brower RG, Liu KD. Fluid balance, diuretic use, and mortality
in acute kidney injury. Clin J Am Soc Nephrol. 2011;6:966–73.

5. Bellomo R, Cass A, Cole L, Finfer S, Gallagher M, Lee J, et al. An observational study fluid balance and patient outcomes in the randomized evaluation of normal vs. augmented level of replacement therapy trial. Crit Care Med. 2012;40:1753–60.

6. Macedo E, Bouchard J, Soroko SH, Chertow GM, Himmelfarb J, Ikizler TA, et al. Fluid accumulation, recognition and staging of acute kidney injury in critically-ill patients. Crit Care. 2010;14:R82.

7. Vidal MG, Ruiz Weisser J, Gonzalez F, Toro MA, Loudet C, Balasini C, et al. Incidence and clinical effects of intra-abdominal hypertension in critically ill patients. Crit Care Med. 2008;36:1823–31.

8. Stone HH, Fulenwider JT. Renal decapsulation in the prevention of post-ischemic oliguria. Ann Surg. 1977;186:343–55.

9. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock 2012. Crit Care Med. 2013;41:580–637.

10. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2:1–138.

11. Thomsen HS, Morcos SK. Contrast media and the kidney: European Society of Urogenital Radiology (ESUR) guidelines. Br J Radiol. 2003;76:513–8.

12. Briguori C, Visconti G, Focaccio A, Airoldi F, Valgimigli M, Sangiorgi GM, et al. Renal Insufficiency after Contrast Media Administration Trial II (REMEDIAL II): RenalGuard system in highrisk patients for contrast-induced acute kidney injury. Circulation. 2011;124:1260–9.

13. Schortgen F, Lacherade JC, Bruneel F, Cattaneo I, Hemery F, Lemaire F, et al. Effects of hydroxyethylstarch and gelatin on renal function in severe sepsis: a multicentre randomised study. Lancet. 2001;357:911–6.

14. Perner A, Haase N, Guttormsen A, Tenhunen J, Klemenzson G, Aneman A, et al. Hydroxyethyl
starch 1300.42 versus Ringer’s acetate in severe sepsis. N Engl J Med. 2012;367:124–34.

15. Myburgh JA, Finfer S, Bellomo R, Billot L, Cass A, Gattas D, et al. Hydroxyethyl starch or saline for fluid resuscitation in intensive care. N Engl J Med. 2012;367:1901–11.

16. Finfer S, Bellomo R, Boyce N, French J, Myburgh J, Norton R. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med. 2004;350:2247–56.

17. Myburgh J, Cooper DJ, Finfer S, Bellomo R, Norton R, Bishop N, et al. Saline or albumin for fluid resuscitation in patients with traumatic brain injury. N Engl J Med. 2007;357:874–84.

18. Finfer S, McEvoy S, Bellomo R, McArthur C, Myburgh J, Norton R. Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis. Intensive Care Med. 2011;37:86–96.

19. Wilcox CS. Regulation of renal blood flow by plasma chloride. J Clin Invest. 1983;71:726–35.

20. Chowdhury AH, Cox EF, Francis ST, Lobo DN. A randomized, controlled, double-blind crossover study on the effects of 2-L infusions of 0.9% saline and plasma-lyte(r) 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers. Ann Surg. 2012;256:18–24.

21. Yunos NM, Bellomo R, Hegarty C, Story D, Ho L, Bailey M. Association between a chloride liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults. JAMA. 2012;308:1566–72.

22. Marik PE, Baram M, Vahid B. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest. 2008;134:172–8.

23. Wan L, Bellomo R, May CN. The effect of normal saline resuscitation on vital organ blood flow in septic sheep. Intensive Care Med. 2006;32:1238–42.

24. Van Biesen W, Yegenaga I, Vanholder R, Verbeke F, Hoste E, Colardyn F, et al. Relationship between fluid status and its management on acute renal failure (ARF) in intensive care unit (ICU) patients with sepsis: a prospective analysis. J Nephrol. 2005;18:54–60.

25. Badin J, Boulain T, Ehrmann S, Skarzynski M, Bretagnol A, Buret J, et al. Relation between mean arterial pressure and renal function in the early phase of shock: a prospective, explorative cohort study. Crit Care. 2011;15:R135.

26. Pranskunas A, Koopmans M, Koetsier PM, Pilvinis V, Boerma EC. Microcirculatory blood flow as a tool to select ICU patients eligible for fluid therapy. Intensive Care Med. 2013;39:612–9.

27. Han SS, Kang KJ, Kwon SJ, Wang SJ, Shin SH, Oh SW, et al. Additional role of urine output crite
rion in defining acute kidney injury. Nephrol Dial Transplant. 2012;27:161–5.

28. Teixeira C, Garzotto F, Piccinni P, Brienza N, Ian nuzzi M, Gramaticopolo S, et al. Fluid balance and urine volume are independent predictors of mortality in acute kidney injury. Crit Care. 2013;17:R14.

29. Uchino S, Doig G, Bellomo R, Morimatsu H, Morgera S, Schetz M, et al. Diuretics and mortality in acute renal failure. Crit Care Med. 2004;32:1669–77.

30. van der Voort PH, Boerma EC, Koopmans M, Zandberg M, de Ruiter J, Gerritsen RT, et al. Furosemide does not improve renal recovery after hemofiltration for acute renal failure in critically ill patients: a double blind randomized controlled trial. Crit Care Med. 2009;37:533–8.
Published
2018-09-28
Section
Literature Review